Epidemiology: Open Access
Open Access

Abstract

Prescription drug misuse and abuse is an epidemic in the U.S. While the U.S. makes up less than 5% of the world population,
we consume 80% of the world’s opioid supply. Since 1999 the sales of opioids have quadrupled as have overdose deaths
associated with prescription opioids. Epidemiological studies have been generally limited to cross-sectional data. The PBSS
database is a longitudinal, multi-state database of de-identified dispensed controlled substance prescription data from 11 states’
Prescription Drug Monitoring Programs (PDMPs). This database was created to serve as 1) an early warning public health
surveillance tool and 2) an evaluation tool, in relation to state and local policies and initiatives, such as prescriber educational
initiatives. As a public health surveillance tool, the database is intended to measure controlled substance prescribing trends
as well as provide indicators of appropriate and inappropriate medical use. The PBSS project has developed 43 prescription
behavior measures which include: overall dispensed prescriptions within drug classes; daily dosage; overlapping prescriptions
within each drug class; questionable activity within a class or classes; payment sources; indicators of possible pill mills;
inappropriate prescribing measures; and pharmacy-based measures of possible inappropriate dispensing. This database has the
ability to detect changes in prescribing patterns in much timelier fashion than other population health data, thereby allowing
time to prepare for and potentially interdict anticipated changes in health outcomes. Examples of types of analyses based on
the PBSS database will be provided during the conference presentation.

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